Skin And Wound Healing

Question 1

Structure

Answer 1

1. Largest organ
2. Surface area of 1.5-2 in adults
3. Weighs 2.7 kg
4. Thickness from 0.5-4 mm
5. Receives 1/3 of the body’s blood supply
6. Continuously growing and repairing

Question 2

Main layers

Answer 2

1. Epidermis
2. dermis

Question 3

Accessory structures

Answer 3

1. Glands
2. Hair
3. Nails

Question 4

Functions

Answer 4

1. Sensory nerve endings
2. Temperature regulation
3. Protection by waterproof layers

Question 5

Has a barrier against

Answer 5

1. Invasion by microorganisms
2. Chemicals
3. Trauma
4. Dehydration

Question 6

Wound healing

Answer 6

1. Wounds can heal following sturing or by being allowed to heal from the bottom up - primary or secondary
2. Faster wound healing from primary intention

Question 7

Factors affects healing

Answer 7

1. Impaired circulation
2. Proliferation
3. Maturation

Question 8

Stages of wound healing

Answer 8

1. Inflammation - coagulation and inflammation
2. Proliferation
3. Maturation

Question 9

Coagulation

Answer 9

1. Lasts 4-5 days
2. Designed to minimise blood tests

Question 10

3 stages of coagulation

Answer 10

1. Blood vessels constrict to minimise blood loss
2. The formation of a platelet plug
3. The clotting cascade results in the development of a fibrin clot to reinforce the platelet plug

Question 11

Inflammation

Answer 11

1. Histamine is released from mast cells
2. Histamine causes vasodilation and increases capillary permebaility
3. White blood cells and plasma protein covers the wound bed
4. Neutrophils arrive first at the wound
5. White blood cells destroy particles with phagocytosis
6. Growth factors attract macrophages to the wound which are larger than neutrophils and destroy larger particles like bacteria

Question 12

Proliferation

Answer 12

At the end of this stage the wound will be covered with new skin

Question 13

Re building phase

Answer 13

1. Granulation
2. Contraction
3. Re-Epithelialisation

Question 14

Granulation phase

Answer 14

1. Myofibroblasts causes contraction of the wound
2. Angiogenesis is the process where the new blood vessels are formed
3. Capillaries bud form existing venules by the wound and its site

Question 15

Contraction

Answer 15

1. Myofibroblasts causes contraction of the wound
2. Start on day 6
3. Reduces surface area of open wounds

Question 16

Epithelialisation

Answer 16

1. Once the surface of the wound is fitted with healthy granulation tissue the process of re-Epithelialisation starts
2. Macrophages release epidermal growth factor which stimulates the proliferation and migration and epithelial cells
3. New epithelial cells originate from wound healing
4. Move over the basement membrane
5. Stop by contact inhibition
6. Require healthy wound bed to move over

Question 17

Maturation

Answer 17

1. Formation of scar tissue
2. Inflammation material is removed leaving collagen fibres
3. Collagen is recognised too five wound maximal strength
4. Take up to 24 days for wound healing

Question 18

Injection

Answer 18

1. Caused by microbial contamination to form pus
2. Pus consists of dead phagocytes, cell debris and inflammatory exudate

Question 19

Diagnosis of infected wound

Answer 19

1. Inflammation
2. Oedema
3. Pain
4. Heat
5. Redness
6. Pus
7. Raised temperature

Question 20

Elderly skin

Answer 20

1. The basal layer becomes less active and the epidermis thins
2. Fewer elastic and collagen fibres which causes wrinkling
3. Sweat glands activity and temperature regulation become less efficient meaning elders are more prone to heat stroke and hypothermia
4. Less sebum is secreted making the skin dryer
5. Less vitamin D is producing leading to reduction in strength
6. Melanocytes are less active therefore more sensitive to sun
7. Fewer active hair follicles therefore hair thins

Question 21

When older the skin could be

Answer 21

1. More fragile and prone to trauma
2. Adhesives on dressing may cause trauma
3. May be dyer
4. More prone to injections

Question 22

Skin cancers

Answer 22

1. BCC is the most common
2. Appears as a painless raised area of skin which may be shiny with small blood vessels or raised with ulcerations

Question 23

Basal cell cancer

Answer 23

1. Grows slowly and can damage the tissue
2. Usually appears as a small, shiny pink or pearly white with a translucent or waxy appearance
3. Can also be red with scaly patch
4. Brown or black pigment within the patch
5. Lump becomes crusty, bleed or turn into an ulcer
6. Does not spread

Question 24

Risk factors

Answer 24

1. Ultraviolet
2. Lighter skin colour
3. Radiotherapy

Question 25

Malignant melanoma

Answer 25

1. Malignant proliferation of melanocytes
2. Often from a mole
3. Ulcerate and bleed

Question 26

Pressure ulcer

Answer 26

A localised injury to the skin or tissue in result of pressure

Question 27

Causes of ulcers

Answer 27

1. External
2. Internal